Kate Lally, MD FACP – Inspiring Hospice and Palliative Medicine Leaders Under 40

This post is from one of the Inspiring Hospice and Palliative Medicine Leaders Under 40. Kate Lally, MD FACP, was selected based on her involvement in AAHPM, educating others about hospice and palliative medicine, participation in charitable work, and mentoring of students or residents. The honoree was then asked who inspired her over the course of her career. We are sharing some of her answers in this post. Check back regularly for posts from other leaders.

Who has most influenced your work in hospice and palliative medicine and what impact has he or she had?
Many people have, and continue to, influence my work. When I teach about having end-of-life conversations I often quote Dr. Nancy Angoff, a mentor of mine in medical school who specialized in treating patients with HIV. When I was in medical school, people were frequently dying from AIDS and Dr. Angoff helped young people navigate an illness that was ending their lives much too soon. In addition to Dr. Angoff, I also often cite a hospice nurse I used to work with, who taught me the language to speak with my patients about the harms vs benefits of various treatments. I was struggling to explain the studies showing the risks associated with tube feeds in a dementia patient to a daughter who was distraught over the imminent death of her father. She was very upset and accused me of starving him. The conversation was failing when the nurse approached and said “Dr. Lally stopped the tube feeds because I asked her to. He was drowning in them, they were going into his lungs and he couldn’t breathe. He is much more comfortable now.” Her approach was so clear and kind, that it made me re-think how I had these conversations. Just recently I worked with a psychiatrist who explained the terminal nature of Alzheimer’s to a family that was struggling with understanding the rapid decline of their mother in an incredibly compassionate and clear way. These people and more have influenced my work and help me get better every day.

Where do you see yourself in 5 years?
I love the field of palliative care. What I love most about it is the broad array of opportunities available to those of us who practice it. I am first and foremost a clinician, and when I go through difficult times at work it is always an encounter with a patient that reminds me how much I love what I do. I recently was able to work with a patient with dementia and agitation in an assisted living, our team had the opportunity to work with geriatric psychiatrist, geriatricians, the PCP, the patient and family and nurses at the assisted living to think though a good plan for this patient to manage his agitation, avoid a hospitalization and reassure his family. What is so exciting about palliative care is that we get to be at the forefront of changing models of care. We get to sit at the table with CEOs and administrators and help design programs to improve the care of our sickest patients in a system that we all know doesn’t serve our most vulnerable well. In the next 5 years I hope to continue to expand and improve my clinical work and continue to have the opportunity to innovate and change the system to provide better care to those who need it most. I hope to become known as an innovator in the field, someone who works across disciplines and specialties to improve end of life care for all out patients.

What is the best advice you have ever received?
I feel like at different points of my life I go around repeating different bits of advice that I have received. Most currently I have been considering something I heard on a documentary about particle-accelerators…

The secret to success is to be able to go from failure to failure with undiminished enthusiasm.

I have this idea that if you fail enough and learn from each of your failures you will get stronger and better with each attempt. From working with our patients to figure out a reasonable plan of care that may deviate from the norm, to working with insurance companies and health systems to think about how to revamp healthcare in a larger sense, our field is all about innovation. We need to make mistakes, learn from them, and try again. Maintaining a positive outlook can be tough at times, but I try to remind myself that it is all part of the process, and that we need to fail in order to succeed.

Leave a Comment